Edward L. v. Bisignano

Background

Edward L. sought judicial review under 42 U.S.C. § 405(g) of the Social Security Administration Commissioner’s final decision denying his applications for disability insurance benefits and supplemental security income. He alleged disability based on several conditions, including a heart attack, an implanted and replaced defibrillator, low blood pressure, cardiogenic vertigo, congestive heart failure, asthma, and attention-deficit/hyperactivity disorder.

The administrative law judge found that Edward L. had severe impairments of cardiomyopathy and coronary artery disease but was not disabled. The judge assessed a residual functional capacity (RFC), meaning the most a person can still do despite physical and mental limitations, for sedentary work with additional restrictions. Those restrictions included lifting or carrying 10 pounds occasionally and less than 10 pounds frequently, sitting for about six hours in an eight-hour workday, standing or walking for about two hours, avoiding certain environmental conditions, and avoiding concentrated exposure to work hazards. Relying on vocational-expert testimony, the judge found that Edward L. could perform work as a final assembler, touch-up screener, or charge account clerk.

Edward L. argued that the decision should be reversed for three reasons: the RFC did not include a needed restriction against working around strong magnetic fields because of his implanted defibrillator; the administrative law judge did not adequately evaluate the persuasiveness of medical findings from Joyce Warkentien, M.D., and Roxana Merz, M.D.; and the RFC’s lifting and carrying restrictions were inconsistent with sedentary work. The Commissioner argued that the decision should be affirmed.

Analysis

Magnetic-field limitation

The medical consultants opined that Edward L. should avoid working around strong magnetic fields. The report explains that strong magnetic or electrical fields can affect an implanted cardiac defibrillator. The administrative law judge mentioned Edward L.’s testimony about the defibrillator and magnetic fields but did not include the consultants’ magnetic-field restriction in the RFC or explain its omission.

The report rejects the argument that the judge’s general statement that Edward L.’s symptoms were not entirely consistent with the evidence adequately addressed this restriction. The report distinguishes the magnetic-field restriction from a subjective symptom: Edward L. was not claiming that he personally felt unable to work near magnetic fields, but that such exposure could affect the device. The report also rejects the argument that the RFC’s reference to avoiding concentrated exposure to “work hazards” included magnetic fields. It notes that the cited Social Security ruling defines work hazards in terms that do not include magnetic fields, and that the consultants’ opinions called for avoiding even moderate exposure.

The report further concludes that the vocational-expert testimony did not resolve the error. The administrative law judge did not include a magnetic-field restriction in the hypothetical questions posed to the vocational expert, so the testimony did not establish that Edward L. could perform the identified jobs with that restriction.

Evaluation of medical findings

The report concludes that the administrative law judge addressed the consistency of the consultants’ findings with other evidence but did not explain their supportability. Supportability concerns how well a medical source justifies a finding with objective evidence and supporting explanations. Consistency concerns how well the finding fits with evidence from other medical and nonmedical sources.

The report also concludes that the administrative law judge did not explain how persuasive each consultant’s findings were overall or whether the judge had considered and rejected the magnetic-field restriction. Because the court could not determine whether the judge would have reached the same result after following the applicable regulations, it found the errors were not harmless and recommended further consideration and explanation.

Lifting and carrying restrictions

The report rejects Edward L.’s argument that the RFC was internally inconsistent because it described sedentary work while allowing him to lift or carry 10 pounds occasionally and less than 10 pounds frequently. The report explains that the administrative law judge expressly made those lifting and carrying limits exceptions to the regulatory definition of sedentary work. It therefore concludes that the RFC was not internally inconsistent or unclear on this point.

Recommendation and procedural posture

The report recommends granting the relief requested in Edward L.’s briefs, denying the Commissioner’s brief, reversing the Commissioner’s final decision, and remanding the matter under sentence four of 42 U.S.C. § 405(g) for further administrative proceedings. The document is a report and recommendation rather than a final district-court order. Its notice states that it is not directly appealable and that the parties may file written objections within the stated deadlines.